FOI Ref: FOI/2022/3790
You asked
Please supply the following information:
Total number of Deaths in Wales from January 2019 to the end of December 2021
Of these deaths how many were COVID Only
How many were deaths within the same period that had other underlying conditions as well as a positive Covid test within 28 days of passing.
If you could also do the same request but for my County of Powys.
Please confirm that although a patient may have had a positive test within 28 days of passing that the death may well have had nothing to do with their positive test. E.g. accidents causing a fatality, terminal patient cases, heart attacks and that in these cases, death was more than likely to have of occurred without a positive test.
Please supply the number of hospital admissions for Wales from Jan 2019 through to end of December 2020 the same dates and if you could identify whether the patients were vaccinated or not.
We said
Thank you for your enquiry.
Total number of deaths in Wales
The total number of deaths registered in Wales from Jan 2019 -- December 2021 is 106,723.
COVID-19 deaths registered in Wales
When a person dies, in most cases a doctor writes a medical certificate of cause of death (MCCD) which is then recorded in the death registration (at a local authority registration office). The details are printed out as the official 'death certificate' for the next of kin. The same information is sent electronically from the registration office to ONS for us to produce statistics about causes of death. For some deaths, such as when the death was due to an accident or violence, there is a coroner's inquest to establish the facts and the coroner then decides the cause of death and sends their findings to the local registrar.
Health conditions are recorded on the death certificate only if the certifying doctor or coroner believed they made some contribution to the death, direct or indirect. The death certificate does not include all health conditions from which the deceased might have suffered if they were not considered relevant.
The death certificate (Annex A (PDF, 224KB)) used in England and Wales is compatible with that recommended by WHO. It is set out in two parts. Part I gives the condition or sequence of conditions leading directly to death, while Part II gives details of any associated conditions that contributed to the death but are not part of the causal sequence.
For statistical purposes one of the health conditions on the death certificate is chosen as the 'underlying cause of death'. The underlying cause of death is defined as the health condition or event that started the train of events leading to death and is worked out according to rules from the World Health Organisation (WHO). COVID-19 is the underlying cause of death in around 92% of deaths where it was mentioned on the death certificate.
If someone dies in circumstances involving an accident, violence or suspicious circumstances, the case is referred to a coroner for investigation. A post-mortem examination is carried out and usually an inquest is held. The Coroner's Court hears all the evidence and follows legal rules of evidence when deciding the causes of death. It is extremely unlikely that a coroner would find that someone was involved in a traffic accident, shark attack or was the victim of violence, because of having COVID-19 or a positive COVID-19 test -- so they would not mention COVID-19 on the death certificate. This applies to any death caused by an accident, violence, poisoning, or other external causes.
Even if in an unusual case a death certificate mentioned both COVID-19 and a shark attack (or other external causes), the World Health Organisation (WHO) rules for coding deaths mean that the attack would be identified as the underlying cause of death in our data.
You can read in detail about the coding of causes of death and identifying the underlying cause in the ONS User guide to mortality statistics and the WHO International Classification of Diseases (ICD-10) instruction manual.
We recommend using our pre-existing conditions methodology to answer this question as it removes any conditions caused by the underlying cause of death.
Please see the published previously answered FOI which will answer your enquiry: Deaths due to COVID-19 in the UK with no pre-existing conditions by age from March 2020 to January 2022 - Office for National Statistics
If this does not meet your needs, we can create a custom output. Special extracts and tabulations of mortality data for England and Wales are available to order (subject to legal frameworks, disclosure control, resources and agreements of costs, where appropriate).
Such enquiries would fall outside of the Freedom of Information regime and should be made to: Health.Data@ons.gov.uk.
Number of deaths within 28 days of a positive test
All the conditions mentioned on the death certificate are coded using the International Classification of Diseases, Tenth Revision (ICD-10). From all of these causes an underlying cause of death is selected using ICD-10 coding rules.
The underlying cause of death is defined by WHO as:
a) the disease or injury that initiated the train of events directly leading to death, or\ b) the circumstances of the accident or violence that produced the fatal injury
We use ICD-10 code U07.1 for COVID-19 deaths with a positive test and U07.2 for suspected COVID-19.
ONS data is different from the figures on COVID-19 deaths published on the government's COVID-19 dashboard managed by UKHSA which shows 'deaths within 28 days of a positive test'.
You can read a blog by Professor John Newton of Public Health England about the complexities of counting COVID-19 deaths and the different methods used.
We do not hold mortality data relating to COVID-19 deaths within 28 days of a positive test. UKHSA would be better placed to answer this enquiry. They can be contacted at enquiries@ukhsa.gov.uk.
COVID-19 deaths and all cause deaths in Powys
We provide all cause and COVID-19 deaths by place of occurrence in our Death registrations and occurrences by local authority and health board.
Mortality data in our Deaths by place of occurrence and local authority publication are published in line with the National Statistics Postcode Lookup which is based on the area of usual residence of the deceased.
The "local authority" is the local area in which the deceased resided. For example, if the deceased lived in Abergavenny, (local authority Monmouthshire), but they were taken to a hospital based in Newport (local authority Gwent) the death would be recorded under Monmouthshire and the place of occurrence would be listed as a hospital death. To clarify, the death would be counted under the local authority where the deceased lived, not by the postcode of where the deceased died.
We do not hold analysis of COVID-19 deaths without pre-existing conditions at this lower geography level.
We can create a custom output. Please refer to the above details in the first section of this response to request this service.
COVID-19 deaths of those who were terminally ill
Unfortunately, we do not hold information regarding how many people who have died from COVID-19 were receiving palliative care or terminally ill, as this information is not recorded on the death certificate.
You may wish to contact the NHS End of Life Care Programme to find out if they hold any relevant statistics. They can be contacted via email at england.palliativeandendoflife@nhs.net.
Further information for Wales can be found on Health in Wales | Palliative Care.
Hospital admissions
We do not hold up-to-date information on hospitalisations. Our data on hospital episodes is obtained from the Hospital Episode Statistics published by NHS Digital with an approximately 3 month delay. Therefore, we use this data to determine pre-existing conditions and general health of individuals, but not to analyse recent hospitalisations due to COVID-19.
This data is held by NHS Digital, so they may be better placed to answer your query. They can be contacted via email at enquiries@nhsdigital.nhs.uk and by telephone at 0300 303 5678.
UK Health Security Agency (UKHSA) publish data that could help answer your enquiry. They publish a weekly surveillance report which looks at the impact on hospitalisations, infection, vaccine effectiveness and COVID-19 mortality. They can be contacted on InformationRights@UKHSA.gov.uk.